NEW DELHI: Several northeastern and other smaller states are spending proportionately more on healthcare than richer states such as Maharashtra, Karnataka and Telangana, according to the National Health Accounts (NHA) 2022-23 data released by the Union health ministry.
Top Spenders Among States
Manipur recorded the highest health expenditure as a proportion of its Gross State Domestic Product (GSDP) at 5.5%, up from 4.6% in 2021-22. Meghalaya spent 4.4% of its GSDP on health, while Nagaland’s spending rose from 3.4% to 3.6% and Mizoram reported 3.2%.
In contrast, some of India’s largest and richest states spent less than 1% of GSDP on health. Karnataka’s health spending dropped from 1.1% in 2021-22 to 0.7% in 2022-23. Maharashtra’s expenditure declined from 1.2% to 0.8%, while Tamil Nadu’s fell from 1.3% to 0.9%. Telangana reported 0.8% and Punjab 0.9%.
Union Territories Show High Spending
Among Union Territories with a legislature, Puducherry reported one of the highest health spending shares at 5% of its GSDP. Experts noted that 2021-22 was an exceptional year due to COVID-19 vaccination drives, emergency healthcare expenditure, and pandemic-related infrastructure expansion, which elevated health spending ratios across states. These figures come at a time when states face rising burdens from non-communicable diseases, ageing populations, and healthcare costs.
Per Capita Health Expenditure Varies Widely
The report also highlighted major disparities in per capita public health spending across states. Among states and UTs with a legislature, Puducherry recorded the highest per capita government health expenditure at Rs 10,675, followed by Mizoram at Rs 9,800, Sikkim at Rs 7,400, Manipur at Rs 7,040, and Meghalaya at Rs 6,843.
Among UTs without a legislature, Chandigarh reported the highest per capita government health expenditure at Rs 20,985, followed by Lakshadweep at Rs 10,594 and Andaman & Nicobar Islands at Rs 8,888.
Larger States' Performance
Among larger states, Kerala reported one of the highest per capita public health expenditures at Rs 3,592, though lower than Rs 4,338 in 2021-22. Karnataka’s per capita spending also declined from Rs 3,259 to Rs 2,333 over the same period.
Uttar Pradesh recorded one of the lowest per capita government health expenditures among major states at Rs 1,419, followed by Jharkhand at Rs 1,536 and Madhya Pradesh at Rs 1,827. Despite low per capita spending, Uttar Pradesh had the country’s highest total government health expenditure at Rs 33,352 crore due to its massive population, followed by Maharashtra at Rs 30,537 crore and Tamil Nadu at Rs 21,517 crore.
Budget Allocation Highlights
The report showed that West Bengal allocated 8.5% of its total government expenditure towards health, one of the highest among major states, while Kerala allocated 8.3% and Uttarakhand 8.2%.
Experts say these figures reflect deep interstate inequalities in healthcare priorities. The data also highlights the continuing dependence of larger states on private healthcare systems despite rising demand for stronger public health infrastructure.
